US5448989A - Medical instrument shaft capable of positive and non-positive linking of segments - Google Patents
Medical instrument shaft capable of positive and non-positive linking of segments Download PDFInfo
- Publication number
- US5448989A US5448989A US08/200,082 US20008294A US5448989A US 5448989 A US5448989 A US 5448989A US 20008294 A US20008294 A US 20008294A US 5448989 A US5448989 A US 5448989A
- Authority
- US
- United States
- Prior art keywords
- segments
- group
- shaft
- distal
- segment
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0052—Constructional details of control elements, e.g. handles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0057—Constructional details of force transmission elements, e.g. control wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/71—Manipulators operated by drive cable mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
- A61B2034/306—Wrists with multiple vertebrae
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/71—Manipulators operated by drive cable mechanisms
- A61B2034/715—Cable tensioning mechanisms for removing slack
Definitions
- the invention is based on a shaft for medical instruments, in particular one for guiding instruments into a body cavity.
- a shaft for medical instruments in particular one for guiding instruments into a body cavity.
- neighboring segments that are hollow on the inside and form sections of the shaft are adjustable in their position by means of control wires, whereby at least two groups of segments are adjustable independently of one another.
- a thin-walled instrument shaft can be bent into the desired shape before use and can then, for example, be guided into a body cavity.
- a disadvantage of an instrument of that type is that it can only be inserted in a limited way, since the position that is set once before the treatment cannot be further altered.
- bendable arrangements of tubes and shafts for use in an endoscope especially for example in the area of bronchoscopy
- the arrangement of tubes has, at least in part, regions of segments that are arranged together in a series and that are movable against each other, whereby for the purpose of setting shaft curvatures, the segments can be moved by means of control wires that are guided into a handle.
- Examples of these are set forth in DE-GM 69 38 905, U.S. Pat. No. 3,190,286, DE-AS 1 291 437, DE-OS 1 766 209, DE-AS 1 816 973, and DE-OS 1 950 035.
- An object of the invention is to provide a shaft for medical instruments, particularly, for guiding of instruments into a body cavity, the curvature of which shaft can easily be changed upon introduction into a body cavity and during the examination of a body cavity, and that, in addition, can be set, that is fixed, in a working position in such a way that it can be handled like a rigid shaft.
- the advantage of this solution in accordance with the invention lies in the fact that the segments of the groups can be adjusted independently of one another.
- the distal part of the shaft can be set and/or adjusted before and during the use in a body cavity, so that it can always be adapted to existing conditions, while the segments of the proximal part of the shaft can be so strongly tensioned that this part of the shaft is rigid.
- the sediments of the second group are held together by tensioning wires that are fixed in an advantageous manner in a tensioning device inside the handle of the instrument. Based upon a particular embodiment of these segments, when there is very strong tension on them, they are no longer held in place in the non-positive manner that exists when they are under low tension, but are instead held in place by means of positive locking.
- adjustment devices are also provided for the segment groups, so that independent adjustment of the two groups can be carried out.
- the adjustment of the individual segments takes place by means of control wires that run through the segments.
- two control wires are provided, which terminate in the associated adjusting devices in the handle.
- the entire shaft can ultimately be moved in either one or two planes.
- several groups with differing segments can be placed in a series one behind the other so that the shaft can be curved in different ways at several sections.
- the handle should then be equipped with adjusting devices in an appropriate manner. Further advantageous embodiments of the invention are described below.
- FIG. 1 is a full view of a shaft according to the invention with an inserted instrument
- FIG. 2 is an enlarged partial view of the shaft
- FIGS. 3-6 are sections of the shaft taken along lines III--III, IV--IV, V--V, VI--VI, respectively, in FIG. 2;
- FIG. 7 is a section of the shaft shown in FIG. 1, partially in section;
- FIG. 8 is another section of the shaft shown in FIG. 1, in section;
- FIG. 9 shows a tensioning device for shaft segments
- FIGS. 10-12 show different embodiments of shaft segments in side view
- FIG. 13 shows a section through the shaft in the region of two adjoining segments
- FIG. 14 is a device for tensioning of shaft segments.
- the shaft 1 in accordance with the invention exhibits over its length three different shaft sections, which are hollow on the inside.
- a handle 7 is provided proximally.
- a first, distal segment group 2 made up of individual segments 5 represents the first shaft section.
- the segments 5 are flexibly linked with one another, and they can be adjusted in their position by means of control wires 10, 11 (see FIGS. 2 and 7) for the purpose of setting shaft curvatures.
- These segments 6 differ in their manner of construction from those in the first group 2, concerning which more detail is provided in the description of FIGS. 2, 7, and 8.
- the segments 6 of the second group 3 are linked with one another in a non-positive manner, and are tensioned by means of a variably adjustable spring force.
- the segments of both groups 2 and 3 are adjustable independently of one another.
- the segments 5, 6 are enclosed by a flexible tube as an outer covering.
- the number of groups does not have to be limited to the two that are shown in this embodiment. There is also the possibility of providing several groups of segments, one after the other, that can be adjusted independently of one another, by means of which the shaft can be curved in different ways in three or more sections. Independent of the number of groups, there is attached to the last proximal group a shaft section (in this embodiment shaft part 4), which is rigid in the usual manner and which ends in the handle 7. An instrument 9 for the treatment of the patient can be fed through the interior lumen 8 of the shaft 1. In FIG. 1, such an instrument 9 is indicated by means of its distal end 9a and its handle 9b.
- FIG. 1 also shows the handle 7 of the shaft 1.
- This handle contains the various devices for the setting and adjusting and for tensioning of the segments 5 and 6 of the groups 2 and 3.
- the handle 7 is also hollow on the inside in known fashion in order to be able to feed the instrument 9 all the way through.
- the handle 7 has an adjusting device 20 which is used to adjust the curvature of the shaft in the region of the first, distal group 2 by means of the control wires 10 and 11.
- a second adjusting device 21 is provided (shown by dotted line in FIG. 1), which is used to adjust the curvature of the segments 6 of the second group 3 by means of the control wires 12 and 13.
- handle 7 also has a tensioning device 16 for fixing the various positions of the segments 6, which are held together by means of tensioning wires 14 and 15.
- FIGS. 2 through 8 and 10 through 12 make clear the embodiments of the segments 5 and 6 which are configured differently.
- the segments 5 of the group 2 have at one end semicircular projections 22, and at the other end, matching recesses 23, which lie diametrically opposed to each other, as is shown in section in accordance with FIG. 7 and in FIG. 10. Segments 5 that are configured in that way, can be joined together because of their shape into one shaft section when the two projections 22 of one segment 5 are inserted into the corresponding recesses 23 of an immediately following segment 5.
- Two segments 5 are connected with each other in an axially flexible manner by means of lateral connecting pieces 24, which could be pins or rivets for example.
- the last distal segment 5a (as seen in FIG. 2), can be closed off with a flat surface, which forms the distal end of shaft 1.
- the control wires 10 and 11 are secured at this last segment 5a, as FIG. 7 makes clear.
- the segments 6 of the second group 3 also exhibit at one end semicircular projections 25, and at the other end matching recesses 26, which lie diametrically opposed to each other in accordance with FIGS. 2 and 11.
- the contours of the projections 25 and the recesses 26 are in the shape of a wavy line, so that when the segments 6 are joined together, the wave crests 27 of the projections 25 of a segment 6 always interlock in the wave troughs 28 of the recesses 26 of the next sequential segment 6.
- FIG. 12 An additional possibility for locking the segments 6 with lock pins is shown in FIG. 12.
- the segments 6 are equipped with wavy line-like projections 25 at one end and with lock pins 6c at the other end.
- the lock pins 6c of one segment can work in combination with the projections 25 of another segment, in which case, depending on the positioning of the two segments relative to each other, the lock pins lock in one of the wave troughs 28 of the neighboring segment.
- the distally last segment 6a of the second group 3 is connected with the proximally first segment 5 of the first group 2 in an axially flexible manner, for example by means of rivets 24.
- the distal end of the rigid shaft part 4 is provided with recesses 26 that correspond to those of the segments 6, and depending on the particular embodiment, either exhibits a lock pin or is made in the shape of a wavy line.
- each of the groups that make up the shaft (in this embodiment, groups 2 and 3), can be established in accordance with the conditions of the treatment, that is, in accordance with the insertion site and the nature of the instruments to be inserted, by selecting an appropriate number of segments 5 and/or 6 to be arranged in a series one after the other.
- FIG. 7 shows the course of the control wires 10 and 11 of the segments 5, which wires continue in the proximal direction to the adjusting device 20, where they are fastened.
- the control wires 10 and 11 run through bores 31 and 32 (see FIGS. 3-5) inside the wall 30 of the segments 5 and 6 of the two groups 2 and 3.
- Adjusting devices of this type are known, so that they can be made as in DE-OS 1 766 209 or as a simple winch in accordance with U.S. Pat. No. 3,190,286. The same holds true for the adjusting device 21. A description of such an adjusting device is therefore omitted.
- the segments 6 of the second group 3 are similarly adjusted by means of control wires 12 and 13, which, in accordance with FIG. 8, are secured at segment 6a and, in a manner analogous to that of control wires 10 and 11 of the segments 5, run through bores of the segments 6 and are guided to the additional adjusting device 21.
- the control wires 12 and 13 can, for example, be fed along with the control wires 10 and 11 or along with the tensioning wires 14 and 15 through the appropriate bores 31 and 32 or 33 and 34, so that no additional bores are necessary. If the control wires 12 and 13 are run along with the control wires 10 and 11 through the bores 31 and 32, then the adjustment of the entire shaft 1 in one plane is possible. If the control wires 12 and 13 are run through the bores 33 and 34 (see FIG. 4), the adjustment of the entire shaft 1 in two planes is possible.
- tensioning wires 14 and 15 that run through the bores 33 and 34 of the segments 6 are secured proximally in a tensioning device 16, while the distal ends of the tensioning wires 14 and 15 are fastened at segment 6a.
- the tensioning device 16 can simply consist of two seats 17 and 18 for a spring 19, for example a coil spring, which as a pressure spring holds the two seats 17 and 18 at a distance from one another.
- the tensioning wires 14 and 15 are fed through the two seats 17 and 18 and the spring 19 and are secured at the proximal seat 17.
- the distal seat 18 has a threaded region 18a, by means of whose adjustment within a counter-thread 7a in the handle 7, a setting of the tension of the segments 6 takes place by changing the distance between the seats and therefore the spring tension and the tensile force of the tensioning wires 14, 15 that hold the segments 6 together.
- the shaft section that is formed by the segments 6 can, for example, be pre-shaped by hand before its introduction into a body cavity, and then by adjusting and increasing the spring pressure by means of the tensioning device 16, a completely rigid shaft section can be attained, while the shaft section formed by the segments 5 remains adjustable.
- the segments 5 of the first group 2 can be adjusted with the control wires 10 and 11 for the purpose of setting the necessary shaft curvature.
- the segments 6 can take part in the curvature and lock into a new position.
- the possibility of an independent adjustment of the segments 6 proves to be advantageous, and this is accomplished by then providing the additional control wires 12 and 13.
- a tensioning of the segments 6 that can be carried out easily and especially quickly can be attained by means of the tensioning device shown in FIG. 14, in which the same or like-working parts are used as in the tensioning device shown in FIGS. 8 and 9. For this reason, these parts and the tensioning device in FIG. 14 are provided with the same, corresponding reference numerals.
- the tensioning wires 14, 15, which are pre-tensioned by the spring 19, can be drawn so tight that the shaft part made up of the segments 6 becomes practically rigid.
- a disc 16b is provided having an eccentric bore 16c, inside of which the ends of the tensioning wires are fastened, for example by means of a ball 16d.
- Disc 16b is adjusted or turned inside of a housing 16e by means of an adjusting lever 16a that comes out of the handle.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Biophysics (AREA)
- Radiology & Medical Imaging (AREA)
- Physics & Mathematics (AREA)
- Pathology (AREA)
- Optics & Photonics (AREA)
- Robotics (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE4305376.9 | 1993-02-22 | ||
DE4305376A DE4305376C1 (de) | 1993-02-22 | 1993-02-22 | Schaft für medizinische Instrumente |
Publications (1)
Publication Number | Publication Date |
---|---|
US5448989A true US5448989A (en) | 1995-09-12 |
Family
ID=6481030
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US08/200,082 Expired - Fee Related US5448989A (en) | 1993-02-22 | 1994-02-18 | Medical instrument shaft capable of positive and non-positive linking of segments |
Country Status (4)
Country | Link |
---|---|
US (1) | US5448989A (de) |
EP (1) | EP0612496B1 (de) |
JP (1) | JP2578314B2 (de) |
DE (2) | DE4305376C1 (de) |
Cited By (127)
Publication number | Priority date | Publication date | Assignee | Title |
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Also Published As
Publication number | Publication date |
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JP2578314B2 (ja) | 1997-02-05 |
DE59400782D1 (de) | 1996-11-14 |
DE4305376C1 (de) | 1994-09-29 |
EP0612496A1 (de) | 1994-08-31 |
EP0612496B1 (de) | 1996-10-09 |
JPH07410A (ja) | 1995-01-06 |
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